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Disseminated coccidioidomycosis

Andrej Spec, Christopher R Barrios, Usama Ahmad, Laurie A Proia
Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. To determine if elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is specific to histoplasmosis or a non-specific marker for disseminated fungal infection or sepsis in general, we retrospectively examined records of all patients diagnosed with an endemic fungal infection (EFI) at Rush University Medical Center from January of 1997 to October of 2012, and a cohort of septic patients with elevated liver enzymes...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Joseph D Forrester, Haiwei Henry Guo, Thomas G Weiser
BACKGROUND: Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. METHODS: Review of the English-language literature...
October 14, 2016: Surgical Infections
María Del Rocío Reyes-Montes, María Ameyali Pérez-Huitrón, Jorge Luis Ocaña-Monroy, María Guadalupe Frías-De-León, Erick Martínez-Herrera, Roberto Arenas, Esperanza Duarte-Escalante
BACKGROUND: Coccidioidomycosis, a potentially fatal fungal infection, is considered an emergent mycotic disease because of the increased incidence of fungal infections registered over recent years. Infection occurs through the inhalation of arthroconidia from two main species of Coccidioides: Coccidioides immitis and C. posadasii, which are both endemic to arid and semi-arid regions of North America. Coccidioides species not only infect humans but can also infect other mammals (land, aquatic, wild or domestic), reptiles and birds...
October 10, 2016: BMC Infectious Diseases
Pedram Ansari Pirsaraei, Kareem Tabsh, Jacob Lentz
We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis...
November 2016: Urology Case Reports
David A Stevens, Yonglong Zhang, Malcolm A Finkelman, Pappagianis Demosthenes, Karl V Clemons, Martinez Marife
Diagnosing coccidioidal meningitis (CM) can be problematic owing to infrequency and/or delay of positivity of CSF culture or CSF antibody, particularly if primary coccidioidal infection is unrecognized. We tested 37 CSF specimens, 26 from confirmed CM and 11 from patients with suspected microbial meningitis without fungal diagnosis, for (1, 3)-beta glucan (BG). CM CSF specimens BG ranged from 18-3300 pg/ml, controls <3.9-103. Diagnostic performance was determined using 31 pg/ml cutoff (bottom of serum range per directions for commercial kit, though further serial dilutions of the standard indicated linearity to 3...
August 24, 2016: Journal of Clinical Microbiology
Colin Fitterer, Zachary Berg, Thorvardur R Halfdanarson, Holenarasipur R Vikram, Shimon Kusne, Robert Orenstein, Maria Teresa Seville, Janis E Blair
Coccidioidomycosis is a common infection in the desert southwestern USA; approximately 3 % of healthy persons in Arizona alone become infected annually. Coccidioidomycosis may be severe in immunocompromised persons, but experience among patients with solid organ cancer has not been fully described. Therefore, we aimed to describe the clinical courses of patients whose cancers were complicated by coccidioidomycosis at our institution, which is located in an area with endemic Coccidioides. To do so, we conducted a retrospective review from January 1, 2000, through December 31, 2014, of all patients with breast, colorectal, or ovarian cancer whose cancer courses were complicated by coccidioidomycosis...
August 4, 2016: Mycopathologia
Gail L Sondermeyer, Lauren A Lee, Debra Gilliss, Duc J Vugia
The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0...
July 2016: Public Health Reports
Joanna K Nelson, Genevieve Giraldeau, Jose G Montoya, Stan Deresinski, Dora Y Ho, Michael Pham
Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics...
September 2016: Open Forum Infectious Diseases
Diana M Simões, Sharon M Dial, Kimberly S Coyner, Anthea E Schick, Thomas P Lewis
BACKGROUND: Coccidioidomycosis is a fungal disease caused by the dimorphic saprophytic fungus Coccidioides immitis or C. posadasii. Primary pulmonary infection can disseminate to cutaneous and subcutaneous tissues, or less commonly direct cutaneous inoculation may occur. HYPOTHESIS/OBJECTIVES: To characterize the historical, clinical, diagnostic and treatment findings in dogs and cats with cutaneous manifestation of coccidioidomycosis. ANIMALS: Twenty three dogs and seventeen cats diagnosed between 2009 and 2015 in Arizona, USA...
October 2016: Veterinary Dermatology
Shayna C Rivard, Elizabeth Satter
A 31-year-old Filipino active duty marine presented with a 2-year history of a waxing and waning nodule on his left cheek that had been incised and drained on multiple occasions. The patient had no significant medical history other than a positive purified protein derivative test with negative chest x-ray finding treated with a 9-month course of isoniazid in 2010. He denied cough, fever, chills, night sweats, weight loss, joint/bone pain, or prior trauma to the area. On initial examination, there was a 1×1-cm erythematous indurated nodule associated with an overlying violaceous scar on his left preauricular cheek...
2016: Skinmed
Michael Loudin, Daniel R Clayburgh, Morgan Hakki
Coccidioidomycosis (valley fever) is caused by the dimorphic fungi Coccidioides immitis or Coccidioides posadasii. Most infections are asymptomatic or result in self-limited pneumonia; extrapulmonary dissemination via either hematogenous or lymphatic spread is rare. Here, we present a case of cervical C. immitis lymphadenitis that resulted in fistula formation to the esophagus via mediastinal extension. This case highlights a very unusual extrapulmonary manifestation of coccidioidomycosis, the difficulty in diagnosing coccidioidal infection when it is not suspected, and the importance of obtaining a thorough exposure history to assist with diagnosis...
2016: Case Reports in Infectious Diseases
Jason Foerter, John Sundell, Penny Vroman
Coccidioidomycosis is an infection caused by inhalation of the Coccidioides fungus. Most infections remain subclinical or are confined to the pulmonary system. Disseminated disease is rare. Traditionally, a combination of imaging modalities has been used to determine disease extent. We suggest (18)F-FDG PET/CT as a single first-line imaging examination to assess disease extent. We present a case of disseminated coccidioidomycosis to the lung, mediastinum, soft tissues, and skeletal system. To our knowledge, no prior case reports demonstrate such widespread disease using PET/CT...
September 2016: Journal of Nuclear Medicine Technology
Ziyad S Hammoudeh, Salvatore Lettieri
PURPOSE: The aim of this report was to present the first known case of coccidioidomycosis involving the temporomandibular joint, review the literature regarding dissemination to the mandible, and to provide treatment recommendations for this challenging condition. METHODS: Coccidioidomycosis of the mandibular condyle was identified in a 30-year-old Somali male residing in Arizona. Due to the difficulty of surgical access and the anticipated temporomandibular joint morbidity of radical condylar debridement, primary medical management was performed...
April 13, 2016: Cranio: the Journal of Craniomandibular Practice
Gaurav Singh, Tejas Patel, Shasa Hu
No abstract text is available yet for this article.
July 2015: JAAD Case Reports
Saman Ratnayake, Ali Ammar, Rodd Rezvani, Greti Petersen
We present a case of a 65-year-old Hispanic man with a history of disseminated cutaneous coccidioidomycosis who presented to the emergency room for progressively worsening abdominal pain associated with shortness of breath. The patient was found to have pleural effusion and moderate ascites on physical examination. Abdominal ultrasound and computed tomography scan were consistent with moderate ascites and portal hypertension but negative for both liver cirrhosis and for venous or arterial thrombosis. Cytology of ascitic fluid was suggestive of portal hypertension and was negative for infection...
October 2015: Journal of Investigative Medicine High Impact Case Reports
Chiung-Yu Hung, Natalia Castro-Lopez, Garry T Cole
Coccidioidomycosis is a potentially life-threatening respiratory disease which is endemic to the southwestern United States and arid regions of Central and South America. It is responsible for approximately 150,000 infections annually in the United States alone. Almost every human organ has been reported to harbor parasitic cells of Coccidioides spp. in collective cases of the disseminated form of this mycosis. Current understanding of the mechanisms of protective immunity against lung infection has been largely derived from murine models of pulmonary coccidioidomycosis...
April 2016: Infection and Immunity
Jessica M Lee, Ana Lia Graciano, Lukasz Dabrowski, Brenik Kuzmic, Mary Anne Tablizo
INTRODUCTION: In contrast to adults, coccidioidomycosis is a rare disease in infants and the mechanisms of disease acquisition are not well described in infants. The purpose of this study was to describe the clinical presentation, treatment, and outcome of pulmonary coccidioidomycosis in infants in an endemic area. METHODS: We performed a retrospective observational study of all patients less than 12 months of age admitted to a tertiary free standing children's hospital from 2003-2012 diagnosed with coccidioidomycosis...
August 2016: Pediatric Pulmonology
Nathan W Stockamp, George R Thompson
Coccidioides immitis and C posadasii are pathogenic dimorphic fungi responsible for causing coccidioidomycosis in the Southwestern United States and Central and South America. Antifungal therapy is beneficial and entails careful periodic assessment with therapies ranging from none or short courses of therapy to prolonged antifungal therapy. Factors that influence the decision to treat are the duration or severity of infection, radiographic findings, anticomplementary titers, presence of underlying immunosuppression, and comorbidities...
March 2016: Infectious Disease Clinics of North America
Onyee Chan, See Wei Low, Rafael Urcis, Naser Mahmoud, Ily Kristine T Yumul, John Leander Z Po, Tirdad T Zangeneh
No abstract text is available yet for this article.
March 2016: American Journal of Medicine
Juana Irma Garza-Chapa, Sylvia Aide Martínez-Cabriales, Jorge Ocampo-Garza, Minerva Gómez-Flores, Jorge Ocampo-Candiani, Oliverio Welsh
Coccidioidomycosis is an endemic fungal infection in the southwestern USA and northern Mexico. It is caused by Coccidioides immitis and C. posadasii. This infection occurs due to the inhalation of airborne arthroconidia, causing a mild pulmonary infection, but most cases are asymptomatic. Disseminated coccidioidomycosis (DC) is a rare entity occurring in less than 1% of all cases, usually in immunocompromised patients, and it carries high risks of morbidity and mortality. The skin is one of the most frequently affected organs and in some cases cutaneous lesions may be the first or only sign of infection...
May 2016: Australasian Journal of Dermatology
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